TPN may be complicated by -

• Characterized by severe fluid and electrolyte shifts in malnourished patients undergoing refeeding. • It can occur with either enteral or parenteral nutrition but is more common with the latter. • It results in hypophosphataemia, hypocalcaemia and hypomagnesaemia. • Risk Factors: Alcohol dependency, severe malnutrition, Anorexics and prolonged periods of fasting. Treatment • Treatment involves matching intakes with requirements and assiduously avoiding overfeeding. • Calorie delivery should be increased slowly and vitamins administered regularly. • Hypophosphataemia and hypomagnesaemia require treatment.